Should providers accept Medicare allowables as payment in full for the uninsured?

Question

Healthcare providers who accept Medicare payments must accept the Medicare allowable, i.e. they must accept as payment in full the cap that Medicare has set for the procedure being paid. However, if a person is uninsured the provider charges that person the usual and customary fee which is always considerably higher than the Medicare allowable. What do you think of Medicare participating providers not being allowed to charge over the Medicare allowable to a person who does not have health insurance?

Answer 1

Actually, the reason behind it is they are shifting the losses of accepting Medicare onto the insured and uninsured.  It's not more price control that we need, it's less.

Cost of anything is tied to what the consumer of the good or service can afford.  Prices are tied to what insurance companies, and thusly corperations and buisnesses, can afford, not individuals.  So, when individuals are put in the situation were they have to compete for access with insurance companies and buisnesses, are we surpised that they can't afford the care?  To make it affordable, we should get rid of the tax credit/deduction buisnesses get for providing employees with coverage.  This will once again reestablish prices to consumer incomes rather than buisness/government profitability.  There will, like anything else, be a transitionary period that may be hard, but in the long run, it's our best shot.

Answer 2

I don't have the answer, but I have some first-hand knowledge.

I had private insurance in the USA in the form of an HMO. I got great medical care. I became eligible for Medicare and lost my private insurance and got acceptable care. I moved to a country where there is socialized medicine and get poor care.

I think the old adage. "You get what you pay for" holds true in the USA's field of medicine. Should it be this way ? Should the non-insured have to pay higher fees (or go without treatment) while the citizens on Medicare get huge discounts? It is the way a capitalistic society works : dog eat dog, and, the rich get richer and the poor get poorer. The poor cannot survive in a capitalistic country, hence huge poverty pockets like New Orleans, Detroit, etc. Life expectancy is directly correlated to income and social status, too.

You asked for an opinion, so for my nickel's worth, I'd say the socialistic approach is much kinder : the rich and poor are treated equally. That means the uninsured should not have to pay a nickel more than anyone else.

Answer 3

Great ides as long as we do not loose too many providers.